As politicians in Scotland and at Westminster face another debate on assisted suicide legislation, I will again be arguing against these dangerous proposals. I have thought and written about this issue a great deal over my career. I gave evidence to a committee of the Scottish Parliament the last time this was debated in 2015, and more recently I have presented my views in Ireland and Australia, where similar proposals are under consideration. Over the years, the more I have studied this question the stronger my opposition has become.
I am opposed to ‘assisted dying’ legislation because, for certain categories of people, it would give social and legal sanction to the provision of the means of suicide. This would create a pernicious exception to a society’s commitment to suicide prevention. If someone who is young and healthy expresses a wish to die they are, or ought to be, helped to live. Whereas if someone fulfils the criteria for assisted suicide then they may no longer be given that care. They may instead be encouraged and assisted to take their own lives.
If suicide can be assisted on the basis that the person perceives themselves to be a “burden on family, friends/caregivers”, as in 60% of assisted suicides in the US state of Oregon, this forces those with similar conditions to have to justify their continued existence. As a friend of mine who suffered from a serious chronic condition once wrote, “The fear of being a burden is a major risk to the survival of those who are chronically ill… [if assisted suicide] were lawful, that sense of burden would be greatly increased for there would be even greater moral pressure to relinquish one’s hold on a burdensome life”.
Some lobby organisations have argued that there are people with terminal illness who take their lives and who might not do so if the law permitted physician assisted suicide. This is a serious argument and, if there were evidence that introducing assisted suicide reduced self-inflicted deaths, I would reconsider my view. However, I have looked into this carefully and find that in every case assisted suicide dramatically increases the number of self-inflicted deaths. It always leads to greater loss of life.
The Better Way campaign, of which I am a supporter, notes the disturbing experience of Canada. The number of assisted suicide deaths there has risen sharply since the law was introduced from just over 1,000 in 2016 to 21,589 in 2020. Almost 4 in 10 patients who opt for it express concern that they are a burden on loved ones. To ignore the experience of other nations or simply claim ‘it won’t happen here’ would be naïve.
This concern is not theoretical for me. It is personal and existential. I have known someone with a disability who died by suicide. His death was a tragedy. The fact that in some jurisdictions his suicide could have been facilitated by the state is deeply disturbing to me. There is a better way for our society to help people implicated by this change in the law than to follow the dangerous route taken by a handful of nations in the West.
I have seen people with chronic conditions and disabilities helped to live well and to die well. I have known of people who were troubled by suicidal thoughts but supported in finding meaning in life. Though the disability activist Alison Davis attempted suicide several times, her “greatest piece of good fortune was that I had friends who did not share my view that my life had no value”. They helped her to “give life another try”.
It is essential that we recognise the importance of suicide prevention for those at all stages of life including those with terminal illness. These people should not be encouraged or assisted to die by suicide but should be helped to live well until the natural end of their lives. This can be done, and I have seen it done. I urge politicians in Scotland and at Westminster to vote down the proposals before them and work to enact truly compassionate policies.
David A. Jones is a Professor of Bioethics at St Mary’s University, Twickenham, and a spokesman for the Better Way campaign